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Dka In Pregnancy Ppt

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Michael P. Carson, Md

2004 NJ ACP Obstetric Medicine Workshop Michael P. Carson, MD Asst. Clin. Prof of Medicine and Obstetrics UMDNJ - RWJMS Chief, Division of General Internal Medicine Saint Peter’s University Hospital Common Disorders Asthma – No changes to management Hypothyroidism Check TSH each trimester. Check it 4 weeks after any dosing change SLE – Be very careful. Increased risk of flare RA flares postpartum Multiple Sclerosis – increased flare risk, follow-up period may not be adequate. Background: Pregnancy & DKA Respiratory alkalosis leads to Bicarb loss by kidneys. HCO3- is ~ 20 Less buffering capacity Ketogenesis is accelerated 2-4 times during pregnancy Less hyperglycemia is required to cause DKA during pregnancy Mortality: Maternal 5-15% Fetal 50-90% Diabetic Ketoacidosis Metabolic Effects of DKA Abnormal Insulin:Glucagon ratio favors triglyceride release from adipose tissue. Then, they’re metabolized to ketones rather than being stored or metabolized to carbon dioxide. Notice a theme here? Ketones: Primary is beta-hydroxybutyric acid Aceto acetic acid Reacts with the nitroprusside test. Responsible for fruity odor on the breath. Diabetic Ketoacidosis Continue reading >>

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Popular Questions

  1. RedhairedNurse

    Your nursing text should point out the difference. I would tell you, but I'd just have to look it up and my books are in storage. I could also google it, but something you can also do as well. Sorry.

  2. RedhairedNurse

    http://books.google.com/books?id=aLt...um=9&ct=result

  3. Ilithya

    In HHNS, blood sugar levels rise, and your body tries to get rid of the excess sugar by passing it into your urine, your body tries to compensate. This usually happens to type 2s
    In DKA there is little to no circulating insulin. DKA occurs mainly, but not exclusively, in Type 1 diabetes because Type 1 diabetes is characterized by a lack of insulin production in the pancreas. It is much less common in Type 2 diabetes because the latter is closely related to cell insensitivity to insulin, not -- at least initially -- to a shortage or absence of insulin. Some Type 2 diabetics have lost their own insulin production and must take external insulin; they have some susceptibility to DKA. You get acidosis in DKA because ketones lower the bloods pH.
    Does that help?

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